1
|
Tusseau M, Belot A. [Rare Autoimmune Diseases Role of Genetics - Example of Systemic Lupus Erythematosus]. Biol Aujourdhui 2024; 218:9-18. [PMID: 39007772 DOI: 10.1051/jbio/2024005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Indexed: 07/16/2024]
Abstract
Systemic lupus erythematosus (SLE) presents a complex clinical landscape with diverse manifestations, suggesting a multifactorial etiology. However, the identification of rare monogenic forms of the disease has shed light on specific genetic defects underlying SLE pathogenesis, offering valuable insights into its underlying mechanisms and clinical heterogeneity. By categorizing these monogenic forms based on the implicated signaling pathways, such as apoptotic body clearance, type I interferon signaling, JAK-STAT pathway dysregulation, innate immune receptor dysfunction and lymphocytic abnormalities, a more nuanced understanding of SLE's molecular basis emerges. Particularly in pediatric populations, where monogenic forms are more prevalent, routine genetic testing becomes increasingly important, with a diagnostic yield of approximately 10% depending on the demographic and methodological factors involved. This approach not only enhances diagnostic accuracy but also informs personalized treatment strategies tailored to the specific molecular defects driving the disease phenotype.
Collapse
Affiliation(s)
- Maud Tusseau
- Laboratoire de génétique des cancers et maladies multifactorielles, Service de génétique médicale, Hospices Civils de Lyon, Bron, France - Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard, Lyon 1, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Alexandre Belot
- Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard, Lyon 1, CNRS UMR5308, ENS de Lyon, Lyon, France - Centre de référence des maladies rhumatologiques inflammatoires, des maladies auto-immunes et interféronopathies systémiques de l'enfant, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France - Service de néphrologie, rhumatologie, dermatologie pédiatrique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
2
|
Tusseau M, Khaldi-Plassart S, Cognard J, Viel S, Khoryati L, Benezech S, Mathieu AL, Rieux-Laucat F, Bader-Meunier B, Belot A. Mendelian Causes of Autoimmunity: the Lupus Phenotype. J Clin Immunol 2024; 44:99. [PMID: 38619739 DOI: 10.1007/s10875-024-01696-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024]
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is characterized by its large heterogeneity in terms of clinical presentation and severity. The pathophysiology of SLE involves an aberrant autoimmune response against various tissues, an excess of apoptotic bodies, and an overproduction of type-I interferon. The genetic contribution to the disease is supported by studies of monozygotic twins, familial clustering, and genome-wide association studies (GWAS) that have identified numerous risk loci. In the early 70s, complement deficiencies led to the description of familial forms of SLE caused by a single gene defect. High-throughput sequencing has recently identified an increasing number of monogenic defects associated with lupus, shaping the concept of monogenic lupus and enhancing our insights into immune tolerance mechanisms. Monogenic lupus (moSLE) should be suspected in patients with either early-onset lupus or syndromic lupus, in male, or in familial cases of lupus. This review discusses the genetic basis of monogenic SLE and proposes its classification based on disrupted pathways. These pathways include defects in the clearance of apoptotic cells or immune complexes, interferonopathies, JAK-STATopathies, TLRopathies, and T and B cell dysregulations.
Collapse
Affiliation(s)
- Maud Tusseau
- Centre International de Recherche en Infectiologie, Inserm, U1111, University Claude Bernard, Lyon 1, Centre National de La Recherche Scientifique, UMR5308, ENS de Lyon, Lyon, France
| | - Samira Khaldi-Plassart
- National Referee Centre for Rheumatic and AutoImmune and Systemic Diseases in Children, European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center, Hospices Civils de Lyon, Lyon, France
- Pediatric Nephrology, Rheumatology, Dermatology Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
| | - Jade Cognard
- Centre International de Recherche en Infectiologie, Inserm, U1111, University Claude Bernard, Lyon 1, Centre National de La Recherche Scientifique, UMR5308, ENS de Lyon, Lyon, France
- Pediatric Nephrology, Rheumatology, Dermatology Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
| | - Sebastien Viel
- Centre International de Recherche en Infectiologie, Inserm, U1111, University Claude Bernard, Lyon 1, Centre National de La Recherche Scientifique, UMR5308, ENS de Lyon, Lyon, France
| | - Liliane Khoryati
- Centre International de Recherche en Infectiologie, Inserm, U1111, University Claude Bernard, Lyon 1, Centre National de La Recherche Scientifique, UMR5308, ENS de Lyon, Lyon, France
| | - Sarah Benezech
- Centre International de Recherche en Infectiologie, Inserm, U1111, University Claude Bernard, Lyon 1, Centre National de La Recherche Scientifique, UMR5308, ENS de Lyon, Lyon, France
| | - Anne-Laure Mathieu
- Centre International de Recherche en Infectiologie, Inserm, U1111, University Claude Bernard, Lyon 1, Centre National de La Recherche Scientifique, UMR5308, ENS de Lyon, Lyon, France
| | - Fréderic Rieux-Laucat
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Université Paris Cité, Paris, France
| | - Brigitte Bader-Meunier
- National Referee Centre for Rheumatic and AutoImmune and Systemic Diseases in Children, European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center, Hospices Civils de Lyon, Lyon, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Université Paris Cité, Paris, France
- Department for Immunology, Hematology and Pediatric Rheumatology, Necker Hospital, APHP, Institut IMAGINE, Paris, France
| | - Alexandre Belot
- Centre International de Recherche en Infectiologie, Inserm, U1111, University Claude Bernard, Lyon 1, Centre National de La Recherche Scientifique, UMR5308, ENS de Lyon, Lyon, France.
- National Referee Centre for Rheumatic and AutoImmune and Systemic Diseases in Children, European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center, Hospices Civils de Lyon, Lyon, France.
- Pediatric Nephrology, Rheumatology, Dermatology Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France.
| |
Collapse
|
5
|
Weill O, Decramer S, Malcus C, Kassai B, Rouvet I, Ginhoux T, Crow YJ, Rieux-Laucat F, Soulas-Sprauel P, Pagnier A, Koné-Paut I, Piram M, Galeotti C, Samaille C, Reumaux H, Lanteri A, Dubois SM, Lefebvre H, Burtey S, Maurier F, Carbasse A, Lemelle I, Meinzer U, Despert V, Flodrops H, Fabien N, Ranchin B, Hachulla E, Bader-Meunier B, Belot A. Familial and syndromic lupus share the same phenotype as other early-onset forms of lupus. Joint Bone Spine 2016; 84:589-593. [PMID: 28039062 DOI: 10.1016/j.jbspin.2016.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Studies of early-onset systemic lupus erythematosus (SLE) have identified monogenic forms of the disease. The primary objective of this study was to compare the clinical and laboratory features of the first patients included in the GENIAL/LUMUGENE cohort to those reported in previous publications. The secondary objective was to determine whether subgroups with a distinctive pattern of clinical and biological features are seen in predominantly genetic forms of SLE. METHODS GENIAL/LUMUGENE is a French nationwide study of the clinical, immunological, and genetic features of juvenile-onset SLE (clinicaltrials.gov #NCT01992666). Clinical and laboratory data from the first 64 patients younger than 18 years who were included in the first part of the study were collected retrospectively. Predefined criteria were used to divide the patients into three subgroups: syndromic SLE (n=10) and familial SLE (n=12) - both presumed to have a strong genetic component - and other forms of early-onset SLE (n=42). RESULTS The predefined criteria for identifying subgroups based on knowledge of the clinical and epidemiological features of monogenic SLE showed a significantly younger age at onset in syndromic SLE (P<0.05) and a lower frequency of joint manifestations in familial SLE. CONCLUSIONS In this study, clinical and epidemiological data alone failed to identify a specific patient subgroup characterized by the same disease presentation or progression. This result may be related to the small sample size or indicate marked heterogeneity of juvenile-onset SLE. Genetic studies using new sequencing techniques in these patients might identify genetic factors responsible for marked phenotypic variability.
Collapse
Affiliation(s)
- Olivia Weill
- Service de Médecine Interne, Néphrologie, Rhumatologie-hypertension pédiatrique, Centre de Référence des maladies Rénales Rares du Sud Ouest, SORARE, Hôpital des enfants, CHU de Toulouse, 31059 Toulouse, France
| | - Stéphane Decramer
- Service de Médecine Interne, Néphrologie, Rhumatologie-hypertension pédiatrique, Centre de Référence des maladies Rénales Rares du Sud Ouest, SORARE, Hôpital des enfants, CHU de Toulouse, 31059 Toulouse, France
| | - Christophe Malcus
- Service d'Immunologie, HĂ´pital Edouard Herriot, Hospices Civils de Lyon, 69437 Lyon, France
| | - Behrouz Kassai
- EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacotoxicologie, CHU-Lyon, 69677 Bron, France; Université de Lyon, Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, 69622 Villeurbanne, France
| | - Isabelle Rouvet
- Centre de biotechnologie cellulaire et Biothèque, Groupe Hospitalier Est, Hospices Civils de Lyon, 69677 Bron, France
| | - Tiphanie Ginhoux
- EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacotoxicologie, CHU-Lyon, 69677 Bron, France
| | - Yanick J Crow
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; INSERM UMR 1163, Laboratory of Neurogenetics and Neuroinflammation Paris Descartes University, Sorbonne-Paris-Cité, Institut Imagine, Hôpital Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Fredéric Rieux-Laucat
- INSERM UMR 1163, Laboratoire d'immunogénétique des maladies auto-immunes pédiatriques, Institut Imagine, 75015 Paris, France
| | - Pauline Soulas-Sprauel
- CNRS UPR 3572 "Immunopathology and Therapeutic Chemistry"/Laboratory of Excellence Medalis, Institute of Molecular and Cellular Biology (IBMC), Department of Clinical Immunology and Internal Medicine, National Reference Center for Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, UFR Sciences pharmaceutiques, Université de Strasbourg, 67200 Illkirch-Graffenstaden, France
| | - Anne Pagnier
- Service de rhumatologie pédiatrique, CHU de Grenoble, 38700 La Tronche, France
| | - Isabelle Koné-Paut
- Service de Rhumatologie Pédiatrique - Centre de Référence des maladies auto-inflammatoires de l'enfant (CeRéMAI), CHU de Bicêtre, APHP, Université Paris-Saclay, Université Paris Sud, 94276 Kremlin Bicêtre, France
| | - Maryam Piram
- Service de Rhumatologie Pédiatrique - Centre de Référence des maladies auto-inflammatoires de l'enfant (CeRéMAI), CHU de Bicêtre, APHP, Université Paris-Saclay, Université Paris Sud, 94276 Kremlin Bicêtre, France
| | - Caroline Galeotti
- Service de Rhumatologie Pédiatrique - Centre de Référence des maladies auto-inflammatoires de l'enfant (CeRéMAI), CHU de Bicêtre, APHP, Université Paris-Saclay, Université Paris Sud, 94276 Kremlin Bicêtre, France
| | | | - HĂ©loĂŻse Reumaux
- Unité de Néphrologie Pédiatriques, CHU de Lille, 59000 Lille, France
| | - Aurélia Lanteri
- Service de médecine interne, centre national de référence des maladies auto-immunes et systémiques rares, Hôpital Claude Huriez, FHU IMMNeNT, Université de Lille, 59037 Lille, France
| | - Sandrine Morell Dubois
- Service de médecine interne, centre national de référence des maladies auto-immunes et systémiques rares, Hôpital Claude Huriez, FHU IMMNeNT, Université de Lille, 59037 Lille, France
| | - Hélène Lefebvre
- Service de médecine interne, centre national de référence des maladies auto-immunes et systémiques rares, Hôpital Claude Huriez, FHU IMMNeNT, Université de Lille, 59037 Lille, France
| | - Stéphane Burtey
- Centre de néphrologie et de transplantation rénale, Aix-Marseille Université, Assistance publique-hôpitaux de Marseille, France
| | | | | | - Irène Lemelle
- Service d'HĂ©mato-Onco PĂ©diatrie, CHRU Nancy, 54511 Vandoeuvre les Nancy, France
| | - Ulrich Meinzer
- Service de Pédiatrie Générale, Maladies Infectieuses et Médecine Interne Pédiatrique, Hôpital Robert Debré, APHP, INSERM, U1149, Centre de recherche sur l'inflammation, 75019 Paris, France
| | - VĂ©ronique Despert
- Service de PĂ©diatrie Grands Enfants-Adolescents, CHU HĂ´pital Sud, 35033 Rennes, France
| | - Hugues Flodrops
- Service de PĂ©diatrie, CHU La RĂ©union Site de Saint-Pierre, BP 350, 97448 Saint-Pierre, France
| | - Nicole Fabien
- Laboratoire d'autoimmunité, Service d'immunologie humorale, Hospices Civils de Lyon, CHLS, 69495 Pierre-Bénite, France
| | - Bruno Ranchin
- Immunologie et rhumatologie pédiatrique, Hôpital Necker, APHP, 75015 Paris, France
| | - Eric Hachulla
- Service de médecine interne, centre national de référence des maladies auto-immunes et systémiques rares, Hôpital Claude Huriez, FHU IMMNeNT, Université de Lille, 59037 Lille, France
| | - Brigitte Bader-Meunier
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; INSERM UMR 1163, Laboratory of Neurogenetics and Neuroinflammation Paris Descartes University, Sorbonne-Paris-Cité, Institut Imagine, Hôpital Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France; Service de néphrologie et rhumatologie pédiatrique, hôpital Femme-Mère-Enfant et université de Lyon 1, INSERM U1111, 69677 Bron, France
| | - Alexandre Belot
- Immunologie et rhumatologie pédiatrique, Hôpital Necker, APHP, 75015 Paris, France.
| |
Collapse
|
6
|
Chen JM, Guo J, Wei CD, Wang CF, Luo HC, Wei YS, Lan Y. The association of CD40 polymorphisms with CD40 serum levels and risk of systemic lupus erythematosus. BMC Genet 2015; 16:121. [PMID: 26474561 PMCID: PMC4608213 DOI: 10.1186/s12863-015-0279-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 10/09/2015] [Indexed: 12/13/2022] Open
Abstract
Background Current evidence shows that the CD40–CD40 ligand (CD40–CD40L) system plays a crucial role in the development, progression and outcome of systemic lupus erythematosus (SLE). The aim of this study was to investigate whether a CD40 gene single nucleotide polymorphism (SNP) is associated with SLE and CD40 expression in the Chinese population. We included controls (n = 220) and patients with either SLE (n =205) in the study. Methods The gene polymorphism was measured using Snapshot SNP genotyping assays and confirmed by sequencing. We analyzed three single nucleotide polymorphisms of CD40 gene rs1883832C/T, rs1569723A/C and rs4810485G/T in 205 patients with SLE and 220 age-and sex-matched controls. Soluble CD40 (sCD40) levels were measured by ELISA. Results There were significant differences in the genotype and allele frequencies of CD40 gene rs1883832C/T polymorphism between the group of patients with SLE and the control group (P < 0.05). sCD40 levels were increased in patients with SLE compared with controls (P < 0.01). Moreover, genotypes carrying the CD40 rs1883832 C/T variant allele were associated with increased CD40 levels compared to the homozygous wild-type genotype in patients with SLE. The rs1883832C/T polymorphism of CD40 and its sCD40 levels were associated with SLE in the Chinese population. Conclusions Our results suggest that CD40 gene may play a role in the development of SLE in the Chinese population.
Collapse
Affiliation(s)
- Jian-Ming Chen
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Jing Guo
- Department of Dermatology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Chuan-Dong Wei
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Chun-Fang Wang
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Hong-Cheng Luo
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Ye-Sheng Wei
- Department of Laboratory Medicine, Affiliated hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| | - Yan Lan
- Department of Dermatology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
| |
Collapse
|